PMID- 32058796
OWN - NLM
STAT- MEDLINE
DCOM- 20201109
LR  - 20201109
IS  - 1552-3365 (Electronic)
IS  - 0363-5465 (Linking)
VI  - 48
IP  - 4
DP  - 2020 Mar
TI  - Defining the Minimal Clinically Important Difference and Patient Acceptable 
      Symptom State for Microfracture of the Knee: A Psychometric Analysis at 
      Short-term Follow-up.
PG  - 876-883
LID - 10.1177/0363546520903279 [doi]
AB  - BACKGROUND: Several studies have investigated failure rates and magnitude of 
      improvement in patient-reported outcome measures after microfracture surgery for 
      focal chondral defects of the knee; however; what constitutes clinically 
      significant improvement in this patient population is poorly understood. PURPOSE: 
      To (1) establish the minimal clinically important difference (MCID) and patient 
      acceptable symptom state (PASS) thresholds for microfracture surgery including 
      the time-dependent nature of these thresholds and (2) identify predictors of 
      achieving the MCID and PASS in patients specifically undergoing microfracture of 
      the knee. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A secure 
      institutional cartilage preservation repository was queried for all patients who 
      underwent microfracture between 2004 and 2017. The distribution method was used 
      to calculate MCID thresholds for the International Knee Documentation Committee 
      (IKDC) score and the Knee injury and Osteoarthritis Outcome Score (KOOS), whereas 
      an anchor-based method was used for the PASS. Multivariate logistic regressions 
      were constructed to determine predictors of achieving the MCID and PASS. RESULTS: 
      A total of 206 patients with a mean +/- SD age of 33.7 +/- 13.2 years and body mass 
      index of 26.9 +/- 5.3 kg/m(2) were included. All thresholds for the MCID and PASS 
      increased over time except for the MCID thresholds for the KOOS Sports and 
      Symptoms subscales. The proportion of patients who achieved the MCID (6 months, 
      78.4%; 12 months, 83.9%; 24 months, 88.6%) and PASS (6 months, 67.7%; 12 months, 
      79.2%; 24 months, 76.1%) generally increased over time. Older age and larger 
      lesion size were negative independent predictors of MCID achievement. Older age 
      was also a negative predictor of the PASS, whereas male sex and higher 
      preoperative KOOS Symptoms and Pain scores were positive independent predictors 
      of the PASS. CONCLUSION: The MCID and PASS thresholds for the IKDC and KOOS in 
      patients undergoing microfracture of the knee are dynamic, with an increasing 
      number of patients achieving the MCID over time. The percentage achieving the 
      PASS increased between 6 and 12 months and then declined slightly at 24 months. 
      Independent predictors of achieving the MCID were lesion size and age at surgery, 
      whereas predictors of achieving the PASS included lesion size, male sex, and 
      greater preoperative KOOS Symptoms and Pain scores.
FAU - Chahla, Jorge
AU  - Chahla J
AD  - Department of Orthopaedic Surgery, Division of Sports Medicine, Rush University 
      Medical Center, Chicago, Illinois, USA.
FAU - Kunze, Kyle N
AU  - Kunze KN
AD  - Department of Orthopaedic Surgery, Division of Sports Medicine, Rush University 
      Medical Center, Chicago, Illinois, USA.
FAU - Tauro, Tracy
AU  - Tauro T
AD  - Department of Orthopaedic Surgery, Division of Sports Medicine, Rush University 
      Medical Center, Chicago, Illinois, USA.
FAU - Wright-Chisem, Joshua
AU  - Wright-Chisem J
AD  - Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New 
      York, USA.
FAU - Williams, Brady T
AU  - Williams BT
AD  - Department of Orthopaedic Surgery, Division of Sports Medicine, Rush University 
      Medical Center, Chicago, Illinois, USA.
FAU - Beletsky, Alexander
AU  - Beletsky A
AD  - Department of Orthopaedic Surgery, Division of Sports Medicine, Rush University 
      Medical Center, Chicago, Illinois, USA.
FAU - Yanke, Adam B
AU  - Yanke AB
AD  - Department of Orthopaedic Surgery, Division of Sports Medicine, Rush University 
      Medical Center, Chicago, Illinois, USA.
FAU - Cole, Brian J
AU  - Cole BJ
AD  - Department of Orthopaedic Surgery, Division of Sports Medicine, Rush University 
      Medical Center, Chicago, Illinois, USA.
LA  - eng
PT  - Journal Article
DEP - 20200214
PL  - United States
TA  - Am J Sports Med
JT  - The American journal of sports medicine
JID - 7609541
SB  - IM
MH  - Adult
MH  - Female
MH  - Follow-Up Studies
MH  - Fractures, Stress/*diagnosis
MH  - Humans
MH  - Knee Injuries/*diagnosis
MH  - Knee Joint/surgery
MH  - Male
MH  - Middle Aged
MH  - *Minimal Clinically Important Difference
MH  - *Psychometrics
MH  - Symptom Assessment
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - clinical outcomes
OT  - microfracture
OT  - minimal clinically important difference
OT  - patient acceptable symptom state
OT  - psychometric
EDAT- 2020/02/15 06:00
MHDA- 2020/11/11 06:00
CRDT- 2020/02/15 06:00
PHST- 2020/02/15 06:00 [pubmed]
PHST- 2020/11/11 06:00 [medline]
PHST- 2020/02/15 06:00 [entrez]
AID - 10.1177/0363546520903279 [doi]
PST - ppublish
SO  - Am J Sports Med. 2020 Mar;48(4):876-883. doi: 10.1177/0363546520903279. Epub 2020 
      Feb 14.